Provider Demographics
NPI:1629717491
Name:DE LEON, MARIE ANGELYN GAOIRAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARIE ANGELYN
Middle Name:GAOIRAN
Last Name:DE LEON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:95-231 WAIPONO ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3249
Mailing Address - Country:US
Mailing Address - Phone:808-744-1322
Mailing Address - Fax:808-744-1321
Practice Address - Street 1:95-231 WAIPONO ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3249
Practice Address - Country:US
Practice Address - Phone:808-744-1322
Practice Address - Fax:808-744-1324
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIRN-85520163WH1000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH1000XNursing Service ProvidersRegistered NurseHospice